Table 1.
Types of self-regulation strategies taught in cognitive-behavioral therapies (CBTs) and mindfulness- and acceptance- based therapies (MABTs)
| A. Cognitive-behavioral therapies | ||
|---|---|---|
| Types of self-regulation strategies commonly taught | General | Substance-specific |
| Examples of how the strategy is enacted for general situations in life (e.g., responding to stressors, improving quality of life, increasing positive affect) | Examples of how the strategy is enacted for decreasing substance use and related harm | |
| Cognitive Reappraisal | When I was upset, I changed the way I was thinking about things to make myself feel better | When I had a craving, I tried to “rethink” things and remind myself about the costs of using/benefits of being sober |
| Stimulus control | When needed, I changed my environment or surroundings to improve my mood | I avoided or left situations that trigger a craving to use alcohol or drugs |
| Distraction | I did something to distract myself and keep my mind off stressful things | When I had a craving, I did something to distract myself from the craving |
| Seeking social support | When I was upset, I reached out to others for support or guidance | When I had a craving, I reached out to friends or family for help |
| Problem solving | When I was upset, I identified the problem at hand and took steps to deal with it | I came up with a plan to avoid using alcohol or drugs in a risky situation |
| Goal setting | I took the time to set a personal goal for myself or keep track of my progress towards my goals | I committed myself to a specific goal for changing my alcohol or drug use (ex. achieve 3 consecutive weeks of abstinence or no binge use) |
| Active communication | I directly communicated my needs or wishes to others in a clear and calm way | I directly refused an offer for alcohol or drugs, or asked others not to use around me |
| Positive activity engagement | I engaged in a positive activity that usually boosts my mood | I got involved in an enjoyable activity that did not involve alcohol or drugs |
| Arousal Reduction | I did something to calm myself down (such as taking deep breaths or going for a walk) | I did something to reduce the intensity of a craving (such as taking deep breaths or going for a walk) |
| Harm reduction | — | I made an effort to stay safe and avoid risks while using alcohol or drugs (ex. limiting amount, going slowly, being around people I trust) |
| Physiological Management | I made an intentional effort to practice good physical health habits (nutrition, exercise, sleep, taking medication consistently, etc.) | I took medication to reduce cravings and cravings (ex. nicotine replacement products, anti-craving pills like naltrexone, opioid replacement medications) |
| B. Mindfulness- and acceptance-based therapies | ||
| Types of self-regulation strategies commonly taught | General | Substance-specific |
| Examples of how the strategy is enacted for general situations in life (e.g., responding to stressors, improving quality of life, increasing positive affect) | Examples of how the strategy is enacted for changing substance use behavior | |
| Mindful awareness | I tried to be fully aware how I felt and what I was doing in the present moment | When I had a craving, I tried to be fully aware of myself and my actions in the moment |
| Mindful acceptance | I tried to accept unpleasant thoughts and feelings and let them be, instead of fighting them | When I had a craving, I tried to accept it and let it come and go, instead of trying to fight or escape it |
| Savoring | I tried to notice and savor the “little pleasures” in life – like food, being outside, music, or a warm shower | I tried to savor or appreciate pleasant activities that did not involve alcohol or drugs |
| Values clarification | I reflected on my personal values and what kind of person I want to be | I reminded myself that staying sober is something I really care about deep down |